Turning Eighteen Changes Who Has Authority
Before your child leaves for college, a Massachusetts health care proxy, durable power of attorney, and HIPAA authorization deserve a place alongside the housing forms and tuition paperwork. Turning eighteen changes who has legal authority, even when very little else about the family’s financial arrangement has changed. You may still pay the bills, carry the health insurance, and get the call whenever something goes wrong. Those responsibilities do not automatically give you access to records or authority to act for an adult child.
Why It Feels Like Such a Strange Dividing Line
For parents, that can feel like a strange dividing line. Last month, you were handling appointments and signing forms as a matter of routine. Now your child may need to authorize your involvement. The point is not that a parent becomes unimportant at eighteen. The law recognizes that your child is an adult with privacy rights and the ability to make personal decisions. Planning gives your child a way to keep trusted people involved while deciding what that involvement should look like.
The Health Care Proxy
A health care proxy addresses who can make medical decisions if your child becomes unable to make those decisions and the requirements for activating the agent’s authority are met. For a college freshman several hours away, knowing who fills that role can be especially helpful. We explain the document itself in our Massachusetts health care proxy FAQ. For this conversation, the important point is that being the parent or the emergency contact is not the same as being the person your adult child has legally appointed.
The HIPAA Authorization
A HIPAA authorization addresses access to health information. Your child can authorize specified people to receive information within the scope of the document, which may help with conversations involving physicians, treatment, or medical billing. It does not automatically give the recipient authority to make medical decisions. Your child should understand what information can be shared, with whom, and for how long, rather than sign a release under the impression that it is just another college form. The federal guidance on HIPAA authorizations covers what they must contain and the right to revoke one.
What HIPAA Does Not Do
It is also important not to overstate the problem. HIPAA does not require hospitals to remain silent in every emergency unless a signed release appears. Federal guidance on disclosures to family and friends explains that providers may share relevant information with family in certain circumstances, including when an incapacitated patient’s best interests support disclosure. But permission under an exception is different from having a clear arrangement your child has chosen in advance. We want families prepared without frightening them with the claim that no paperwork always means no information.
The Durable Power of Attorney
The durable power of attorney concerns financial and other authorized matters. Even a student with relatively few assets may have a bank account, lease, insurance issues, or obligations that need attention during an illness or extended absence. The authority should fit the child’s circumstances and wishes. Our Massachusetts durable power of attorney FAQ discusses the document more fully. Here, the distinction is that medical information access does not authorize a parent to handle a financial transaction, and financial authority does not automatically authorize medical decisions.
College Records Are a Separate Question
Education records are generally governed by FERPA, and rights ordinarily transfer to the student at eighteen or upon attendance at a postsecondary institution. A school may have its own consent and parent-access procedures, and certain student health records may also fall under FERPA rather than HIPAA. Paying tuition does not guarantee unrestricted access to grades or other records. Review the college’s forms with your child instead of assuming the estate planning documents cover the entire campus.
These Are Your Child’s Choices to Make
These should be your child’s informed choices, including whom to name and whom to list as a backup. Once the documents are signed, make sure the appropriate people can obtain them, and consider whether attending school in another state calls for additional review. This does not have to become a dramatic conversation about everything that could go wrong. It can be part of helping your child enter adulthood with a practical arrangement for getting help when help is needed.
Start with a free 15-minute consult call with Nicole Ott, our Lead Intake Coordinator. Tell her when your child leaves and where they are headed. That is usually enough for us to say what should be signed before the car is packed.
